Effects of Exercises and Physiotherapeutic Modalities on Diabetes Mellitus and Its Complications - A Narrative Review

Abstract

<b>Background: </b>Diabetes mellitus is slowly and steadily increasing with an estimate that 783 million people will be living with this condition by the end of 2045. Diabetic neuropathy, a complication of diabetes mellitus, is experienced by more than 50% to 70% of all patients with diabetes and results in decreased sensations, proprioception, reflexes, and strength in the lower limbs. This article includes effects of different types of exercises and physiotherapeutic modalities on diabetes mellitus and its complications. <b>Methods:</b> A literature search was carried out in PubMed and Google Scholar by using key words including <i>diabetes mellitus, diabetic neuropathy, diabetic foot, exercises, modalities,</i> and <i>quality of life</i>. Thirty free full-text articles published between 2016 and 2022 were selected and reviewed to know about the recent trends, under 4 different sub-topics: (1) effects of exercises on diabetic neuropathy and diabetic foot, (2) effects of physiotherapeutic modalities on diabetes mellitus/diabetic neuropathy, (3) effects of exercises on diabetes mellitus, (4) effects of exercises on quality of life in diabetic patients. Case reports, randomized controlled trials, a cross-sectional study, and a pilot study, published in only the English language were included, regardless of country of origin. <b>Discussion:</b> The studies deduced that the patients who followed any type of exercise protocol and used physiotherapeutic modalities in addition to following only pharmacological management showed significant decrease in the symptoms of diabetes mellitus and diabetic neuropathy. Various exercise protocols have produced improvements in diabetic neuropathy symptoms, with significant improvement in self-esteem, mental health, anxiety, depression, and insomnia in diabetic patients. <b>Conclusion:</b> This review suggests that implementation of exercises significantly benefited the overall functional gait and balance along with an improvement in the signs and symptoms of diabetic and diabetic neuropathic patients thereby increasing the individual's quality of life. Similarly, the use of recent modalities has proven to be remarkably efficient in reducing the size of wound ulcers.